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COVID-19: R0 is lower where outbreak is larger

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  • Battiston, Pietro
  • Gamba, Simona

Abstract

We use daily data from Lombardy, the Italian region most affected by the COVID-19 outbreak, to calibrate a SIR model on each municipality. Municipalities with a higher initial number of cases feature a lower rate of diffusion, not attributable to herd immunity: there is a robust and strongly significant negative correlation between the estimated basic reproduction number (R0) and the initial outbreak size. This represents novel evidence of the prevalence-response elasticity in a cross-sectional setting, characterized by a same health system and homogeneous social distancing regulations. By ruling out alternative explanations, we conclude that a higher number of cases causes changes of behavior, such as a more strict adoption of social distancing measures among the population, that reduce the spread. This finding calls for the distribution of detailed epidemiological data to populations affected by COVID-19 outbreaks.

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  • Battiston, Pietro & Gamba, Simona, 2021. "COVID-19: R0 is lower where outbreak is larger," Health Policy, Elsevier, vol. 125(2), pages 141-147.
  • Handle: RePEc:eee:hepoli:v:125:y:2021:i:2:p:141-147
    DOI: 10.1016/j.healthpol.2020.10.017
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    1. Philipson, Tomas, 2000. "Economic epidemiology and infectious diseases," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 33, pages 1761-1799, Elsevier.
    2. Alexander Chudik & M. Hashem Pesaran & Alessandro Rebucci, 2020. "Voluntary and Mandatory Social Distancing: Evidence on COVID-19 Exposure Rates from Chinese Provinces and Selected Countries," Globalization Institute Working Papers 382, Federal Reserve Bank of Dallas.
    3. Oster, Emily, 2012. "HIV and sexual behavior change: Why not Africa?," Journal of Health Economics, Elsevier, vol. 31(1), pages 35-49.
    4. Jennifer Beam Dowd & Liliana Andriano & David M. Brazel & Valentina Rotondi & Per Block & Xuejie Ding & Yan Liu & Melinda C. Mills, 2020. "Demographic science aids in understanding the spread and fatality rates of COVID-19," Proceedings of the National Academy of Sciences, Proceedings of the National Academy of Sciences, vol. 117(18), pages 9696-9698, May.
    5. Geoffard, Pierre-Yves & Philipson, Tomas, 1996. "Rational Epidemics and Their Public Control," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 37(3), pages 603-624, August.
    6. Ichino, Andrea & Favero, Carlo A. & Rustichini, Aldo, 2020. "Restarting the economy while saving lives under Covid-19," CEPR Discussion Papers 14664, C.E.P.R. Discussion Papers.
    7. Richard A. Kronmal, 1993. "Spurious Correlation and the Fallacy of the Ratio Standard Revisited," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 156(3), pages 379-392, May.
    8. Lewis, Jeffrey B. & Linzer, Drew A., 2005. "Estimating Regression Models in Which the Dependent Variable Is Based on Estimates," Political Analysis, Cambridge University Press, vol. 13(4), pages 345-364.
    9. Andrew Atkeson, 2020. "How Deadly is COVID-19? Understanding the Difficulties with Estimation of its Fatality Rate," Staff Report 598, Federal Reserve Bank of Minneapolis.
    10. Callum Jones & Thomas Philippon & Venky Venkateswaran, 2021. "Optimal Mitigation Policies in a Pandemic: Social Distancing and Working from Home [A simple planning problem for covid-19 lockdown]," The Review of Financial Studies, Society for Financial Studies, vol. 34(11), pages 5188-5223.
    11. Sabat, Iryna & Neuman-Böhme, Sebastian & Varghese, Nirosha Elsem & Barros, Pedro Pita & Brouwer, Werner & van Exel, Job & Schreyögg, Jonas & Stargardt, Tom, 2020. "United but divided: Policy responses and people’s perceptions in the EU during the COVID-19 outbreak," Health Policy, Elsevier, vol. 124(9), pages 909-918.
    12. Fenichel, Eli P., 2013. "Economic considerations for social distancing and behavioral based policies during an epidemic," Journal of Health Economics, Elsevier, vol. 32(2), pages 440-451.
    13. John Mullahy, 1999. "It'll only hurt a second? Microeconomic determinants of who gets flu shots," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 9-24, February.
    14. Tomas Philipson, 1996. "Private Vaccination and Public Health: An Empirical Examination for U.S. Measles," Journal of Human Resources, University of Wisconsin Press, vol. 31(3), pages 611-630.
    15. Avner Ahituv & V. Joseph Hotz & Tomas Philipson, 1996. "The Responsiveness of the Demand for Condoms to the Local Prevalence of AIDS," Journal of Human Resources, University of Wisconsin Press, vol. 31(4), pages 869-897.
    16. Michael Greenstone & Vishan Nigam, 2020. "Does Social Distancing Matter?," Working Papers 2020-26, Becker Friedman Institute for Research In Economics.
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    Cited by:

    1. Matthias Klumpp & Dominic Loske & Silvio Bicciato, 2022. "COVID-19 health policy evaluation: integrating health and economic perspectives with a data envelopment analysis approach," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(8), pages 1263-1285, November.
    2. Alexander Chudik & M. Hashem Pesaran & Alessandro Rebucci, 2023. "Social Distancing, Vaccination and Evolution of COVID-19 Transmission Rates in Europe," IMF Economic Review, Palgrave Macmillan;International Monetary Fund, vol. 71(2), pages 474-508, June.
    3. Alexander Chudik & M. Hashem Pesaran & Alessandro Rebucci, 2021. "COVID-19 Time-Varying Reproduction Numbers Worldwide: An Empirical Analysis of Mandatory and Voluntary Social Distancing," Globalization Institute Working Papers 407, Federal Reserve Bank of Dallas.
    4. Wim Naudé & Ricardo Vinuesa, 2020. "Data, global development, and COVID-19: Lessons and consequences," WIDER Working Paper Series wp-2020-109, World Institute for Development Economic Research (UNU-WIDER).
    5. Muhammad Fayyaz Nazir & Shahzadah Fahed Qureshi, 2023. "Applying Structural Equation Modelling to Understand the Implementation of Social Distancing in the Professional Lives of Healthcare Workers," IJERPH, MDPI, vol. 20(5), pages 1-32, March.
    6. Celidoni, Martina & Costa-Font, Joan & Salmasi, Luca, 2023. "Mobility restrictions and alcohol use during lockdown: “A still and dry pandemic for the many”?," Economics & Human Biology, Elsevier, vol. 50(C).
    7. Celidoni, Martina & Costa-Font, Joan & Salmasi, Luca, 2023. "Mobility restrictions and alcohol use during lockdown: "a still and dry pandemic for the many"?," LSE Research Online Documents on Economics 119467, London School of Economics and Political Science, LSE Library.
    8. P. Battiston & M. Menegatti, 2022. "Interaction in Prevention: A General Theory and an Application to COVID-19 Pandemic," Economics Department Working Papers 2022-EP02, Department of Economics, Parma University (Italy).

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    More about this item

    Keywords

    COVID-19; Prevalence-response elasticity; Basic reproduction number; Social distancing; Containment;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • C53 - Mathematical and Quantitative Methods - - Econometric Modeling - - - Forecasting and Prediction Models; Simulation Methods
    • C22 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Time-Series Models; Dynamic Quantile Regressions; Dynamic Treatment Effect Models; Diffusion Processes

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